OBJECTIVES: To evaluate in a prospective, randomised trial the surgical efficiency and safety of a new energy source enabling a continuous bipolar plasma vaporisation of the prostate (C-BPVP) by comparing with standard vaporisation (S-BPVP) and monopolar transurethral resection of the prostate (TURP) in men with benign prostatic hyperplasia (BPH). To comparatively assess the short-term functional outcome of the three methods.
PATIENTS AND METHODS: In all, 180 men with BPH with prostate volumes of 30-80 mL, maximum urinary flow rates (Qmax ) of < 10 mL/s and International Prostate Symptom Score (IPSS) of > 19 were equally randomised for C-BPVP, S-BPVP and monopolar TURP. All men were evaluated preoperatively and at 1, 3 and 6 months after surgery by IPSS, Qmax, health-related quality of life (HRQL) score and post-void residual urine volume (PVR). The prostate volume and PSA level were postoperatively assessed at 6 months.
RESULTS: The mean operation time was significantly reduced in C-BPVP vs S-BPVP and TURP, with a substantial 22.4% and 39.1% decrease in duration for C-BPVP when compared with S-BPVP and TURP, respectively. The mean haemoglobin level decrease (0.4 and 0.6 vs 1.4 g/dL), capsular perforation rate (1.7% and 3.3% vs 10%), postoperative haematuria rate (1.7% and 1.7% vs 13.3%), catheterisation period (24.1 and 23.9 vs 73.6 h) and hospital stay (2.1 and 2.2 vs 4.5 days) were significantly lower for C-BPVP and S-BPVP vs TURP. At 1, 3 and 6 months follow-up, there were statistically ameliorated IPSS and Qmax measurements in the C-BPVP and S-BPVP series, while similar HRQL scores, PVRs, PSA levels and postoperative prostate volumes were found in all three study arms.
CONCLUSIONS: The operation time for C-BPVP was on average 20% and 40% quicker than S-BPVP and TURP, respectively. Both C-BPVP and S-BPVP had better perioperative safety and improved follow-up voiding and symptom scores than TURP.
Written by:
Geavlete B, Stanescu F, Moldoveanu C, Geavlete P Are you the author?
Department of Urology, 'Saint John' Emergency Clinical Hospital, Bucharest, Romania
Reference: BJU Int. 2013 Jun 13 (Epub ahead of print)
doi: 10.1111/bju.12290
PubMed Abstract
PMID: 24053794
Go "Beyond the Abstract" - Read an article written by the authors for UroToday.com
